Aside from their outlandishly inethical practices with regard to manipulating research, publications, and policy, Philip Morris et al. have one product line, and that product line is known to be highly addictive, toxic, and lethal. Profits used to fund tobacco industry grants are earned at the cost of millions of lives and billions of dollars worldwide. Why would any academic health center solicit and accept grants and gifts funded solely and directly through the sale of a product they themselves must counsel each and every patient, employee, faculty, student, and community member to avoid or stop using … an industry in direct conflict with their mission to protect and advance public and personal health.

Update: Science and The Chronicle of Higher Education (which includes a thread of comments) note that Philip Morris ended its PM External Research Program. However, this is not the end of PM funding at Universities.
Meantime, thanks to Orac for posting old cigarette ads like this one reporting a study on the lack of adverse health effects of smoking Chesterfields … seems that fancy new Philip Morris center doesn’t need to do harm reduction research after all:

Smoking-related diseases claim an estimated 438,000 American lives each year, including those affected indirectly, such as babies born prematurely due to prenatal maternal smoking and victims of “secondhand” exposure to tobacco’s carcinogens.”

Mentorlesssaid

iGrrrlsaid

Thanks, Mentorless, for calling a dead fish stinking. I lost three parents to smoking-related illness. (Father to emphysema, mother to lung cancer, and beloved stepfather to acute myelogenous leukemia due to post-surgery radiation treatments for lung cancer.) My mother’s greatest regret was the fact that my brother and I were born under a literal cloud, reassured by the industry that all was well.

Thanks, writedit, for keeping our attention on this.

Thanks, iGrrrl, for the good word – though so genuinely sorry at the incomprehensible pain this industry has inflicted upon you. I realize these posts are out of line with the rest of the blog, but I sincerely wish researchers eager to accept tobacco grants would for a moment consider the true cost paid to fund their work. Harm reduction my ass. Stop selling the damn stuff. I relocated to be closer to my mom, who, on oxygen and gasping for breath, remains eternally addicted to that deadly but highly profitable OTC drug the tobacco giants swore was not addictive – and not really harmful either. The cloud I grew up under inspired me not, thankfully, to smoke but to counter the fraud perpetrated by these robber barrons as best I can. – writedit

[…] Yet some academic medical centers feel no conflict of interest in accepting research awards and enthusiastic partnerships (see page 8 or RTD excerpt) funded by the sale of said addictive and lethal and economically […]

The issue is the conflict in accepting funding earned through the sale of products specifically designed and known to addict and often ultimately kill patients who seek and pay for treatment from these same academic medical centers. If tobacco companies stopped selling cigarettes etc. while they funded universities to study & help develop a non-lethal product line, then sure – basic research can serve the greater good no matter who is footing the bill. But as long as they use profits earned on the sale of these products to fund the research, no. That money, unlike any other source of research funding to academic medical centers, is wholly & unambiguously tainted.

”Appropriate disclosure” might read something like “this research was funded by the sale of 471,654,982 packs of cigarettes that caused the premature death of 89,978,651 smokers and, via second-hand smoke, 3,325 nonsmokers who directly and through insurance/Medicare/Medicaid paid our academic medical center $14,658,243 for care required due to their exposure to tobacco smoke.”

Even more appropriate disclosure by academic medical centers of their acceptance of cigarette sale profits would be to their patients, employees, philanthropic donors, and other research sponsors. I would not want to seek care from or spend my health care dollars at or make donations to an institution that profits three times from the sale of tobacco products: once from their initial sale (to future patients) via funding from the tobacco industry (for research or as gifts/donations); twice from the medical care expenditures associated with treating patients who bought the products and hence filled the tobacco industry research award coffers; and thrice from extramural sponsors such as the National Institutes of Health that pay for research to diagnosis and treat the many disorders associated with the use of tobacco products whose purchase funded the tobacco industry largess to the very same academic medical center.

Those academic medical institutions that choose to hide the true depth of their involvement with the tobacco industry clearly do not engage in appropriate disclosue of their conflict of interest, their conflict of commitment, or any lingering conflict of conscience.

Big tobacco has reinvented itself only in its ability to slip farther under the radar with regard to its manipulation of research and, further downstream, policy decisions. The tobacco industry is still using manipulated research & researchers to fight policies to prevent exposure to second-hand smoke, to muddle the connection between smoking and other lung disease such as COPD (ie, emphysema & chronic bronchitis … statistical genetics is a many-splendored thing), to interfere with successful smoking prevention campaigns by interjecting their own, etc.

At no charge, I’m happy to tell Philip Morris USA that they can achieve 100% harm reduction by not selling tobacco products – no fancy statistical machinations needed. Even better, the money they save not paying academic health centers to conduct tobacco harm-reduction research can go toward subsidizing nicotine patches, gum, inhalers, etc. and anti-nicotine medications and other therapies until current addicts have recovered from this commercially created and profit-driven disorder.

And a parting quip I’ve always appreciated: Having a smoking section in a restaurant (or anywhere else) is like having a peeing section in a swimming pool.

“and thrice from extramural sponsors such as the National Institutes of Health that pay for research to diagnosis and treat the many disorders associated with the use of tobacco products whose purchase funded the tobacco industry largess to the very same academic medical center.”

not defending the interests of the tobacco industry here. nor any practice anywhere of “shading” scientific conduct based on corporate interests. i sympathize entirely with rage against an industry which so willingly and enthusiastically poisoned people and have been most effective in not having to pay the piper even when caught dead to rights. really I do.

however.

taking it, as you may assume, from the perspective of the scientist who may seek or hold funding that you consider tainted by BigTobaccy. Also, from the perspective of those who work on tobacco-related public health science. your above comment starts to veer into the territory of suggesting that any scientific result that might conceivably help the tobacco companies shouldn’t be done. alpha-7 cognitive enhancer study okay with you? or tainted?

what about anti-addiction research? wouldn’t effective ways to break nicotine addiction just increase sales because people wouldn’t be as worried about getting hooked? what about that donny and dierker 07 paper which might be taken as suggesting a less-than-obligatory risk of dependence even with substantial use? mightn’t it encourage some people to smoke more?

My COI: funding to date is all from the NIH, so untried virtue on the front of accepting ‘tainted’ research funds deriving from tobacco sales directly. Note that BigTobaccy pays taxes so in some senses NIH dollars are “tainted” anyway. some small fraction of my research program touches on nicotinic receptor function, thus it is conceivable that I may have or at some point produce work that would be seen as helpful to the defense of the tobacco industry (also likely to contribute to the critique of the industry, of course. data tends to be a multi-sided sword…). finally, while I don’t happen to be up on the details I find it overwhelmingly likely that my Institution accepts money coming in one way or another from BigTobaccy so going by the sort of critique you launch at Institutions, well, I’m likely under that as well.

Addiction … if you make it so people can stop using these substances at any point, will they? Would most people be content to limit themselves to enjoying just a snort or two of cocaine each year (see p 051 of Our Dumb World, 73rd ed, for infographic on “how cocaine gets to you”)? A cigarette only when they had a grant application deadline pending & needed a mental boost to sharpen those specific aims?

Or is the key to prevent initiation of use after witnessing an addictive product’s positive effects? I know you’ve blogged about kids’ risk perception of ecstacy plummetting, resulting in increased use. When my mom (lifelong smoker) & I lived in an industrial slum, she never once asked why I walked a couple miles through snow & ice to school rather than wait at the bus stop. Completely unrelated to any prevention campaigns, I simply had no interest in experiencing what was being peddled then or the more costly options later offered by research colleagues, though I witnessed their enjoyment of the same regularly. And life has given me plenty of inspiration for better living through chemistry. Not avoiding risk (or being stupid) necessarily (bike year-round to work in all cities, including Boston, & have regularly tasted pavement, nearly rolled my Suzuki Samari off an NH mountain, etc.) – just apathetic to this particular “experience”. Why are some people vulnerable to such solicitation & desire to experience these effects and others not? Given the 60s tales from siblings at the right age for that era, genes cannot be the sole answer.

I’ll monitor DrugMonkey for musings on this, which would be the more appropriate forum for continued conversation. – writedit

Research conducted anywhere with funds from federal or other non-tobacco industry sources that may help the tobacco industry (whether intentionally or not) – no problem. In fact, I have no problem with tobacco companies funding agricultural research at land grant universities.

My problem is with academic medical centers engaging this industry at any level – research, gifts, endowed chairs, etc. You have in mind investigator-initiated research grants to fund a specific project (probably one the investigator does not view as enhancing the sale of tobacco products). I have in mind tobacco companies using academic medical centers as research service organizations via master agreements and task orders in which control over projects conducted, reviewed, disseminated, etc. lies with the industry sponsor. Or seven-figure donations made directly from major tobacco companies to NCI-designated cancer centers. Or eight-figure gifts to schools of medicine.

Academic medical centers have a mission that is utterly incompatible with the tobacco industry, their product line, and their past and current efforts to hinder public health policy making. Unlike the other vice industries, the tobacco industry markets & sells a product that they know will, when used as directed in a responsible manner, addict the user and negatively impact the health of the user and any bystanders.

The primary consideration is not one of logic (after all, a tobacco-funded project could be the one to discover the cure for cancer) but of integrity. You quickly note that you are “not defending the interests of the tobacco industry.” No one defends Philip Morris et al. as ethical pillars of society. Does the fact that they come bearing gifts of money balance out their unethical behavior in the negative side of the ledger? Would we be having this discussion – would academic medical centers seek to partner with this industry – if there were not large sums of money involved – particularly at a time when such cash boluses are difficult to secure from the NIH and other sponsors of scientific research?

On the NIH connection (which I’ll agree is tenuous) … While nonprofit organizations such as the American Lung Association and the Robert Wood Johnson Foundation can & do refuse to award grants to researchers who accept tobacco money, the NIH can draw no distinction – & no argument from me that they should start doing so. I’m just pointing out that academic medical centers can simultaneously benefit both from the sale of the unhealthy product and federal research funding into treatments for the health problems caused by the sale & use of this same product.

I don’t believe your employer falls in this category (academic medical center, that is), but I would still hope they would prefer not to negotiate with an industry whose invovlement in the community of science has historically been devoid of integrity. And my problem is not with individual investigators but with those in leadership positions (especially research but also the clinical care enterprise) who set the moral tone for their institution. That you don’t know whether your employer accepts tobacco funding suggests something less than the FASEB-recommended transparency with regard to industry relationships (at least UC & Stanford had public debates). My current institution does not accept grants or gifts of any sort from the tobacco industry, and those faculty desirous of the academic freedom to solicit and receive tobacco funding are free to move to an institution unencumbered by such ethical concerns. I haven’t done a formal survey, but I suspect the N would be somewhere around zero.

And I refer you back to the scheduled events that inspired this post. Not likely they would be debating tainted money or reputations. A rousing discussion of the benefits of peat moss would be more probable …

[…] note that Philip Morris ended its PM External Research Program. However, this is not the end of PM funding at Universities, particularly that conducted under highly secretive master research (& research services) […]

[…] Then there is the lack of disclosure due to the principals being so blinded to the potential for COI (or what a reasonable person might perceive as COI), as evidenced doubly at Cornell last week in terms of accepting (& hiding) tobacco industry funding for early CT screening for lung cancer (thank you NYT) and not disclosing multiple patent and licensing deals directly related to the screening technology (thank you Cancer Letter) … and then not even coming fully clean with JAMA (with regard to source of foundation funds). (I probably don’t need to remind you where I stand on University acceptance of tobacco industry largess.) […]